Timing of disc surgery after iohexol myelography and its effect on the incidence of postoperative problems.
Year: 1986
Type: article
Abstract: A skull fracture is associated with an intracranial mass lesion in three quarters of patients.3Absence of a fracture does not exclude serious head injury: 35% of patients in coma and 200/% of those dying after head injury do not have a skull fracture.3Computed tomography is mandatory for head injured patients in coma (Glasgow coma scale 8), and measurement of intracranial pressure may be useful.Half of head injured patients admitted in coma have a raised intracranial pressure, and intracranial pressure is raised in 30%/o of cases without haematoma.4Raised intracranial pressure is also a feature of severe near drowning, reflecting the primary hypoxic insult.When the intracranial pressure is greater than 20 mm Hg after near drowning outcome is poor (death in 70%/o of patients, a vegetative state in 30%). 5 In our patient attributing the neurological signs to severe head injury led to unnecessary monitoring of intracranial pressure and might have led inexperienced staff to diagnose post-traumatic brain stem failure and withdraw supportive treatment.When examining unconscious patients the core temperature should be measured and clinical signs interpreted accordingly.
Source: BMJ
Authors: D Riley, J E Woodyard, H S Dabis
Institution: Western General Hospital
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2006337289